Since the end of 2019, the novel coronavirus infection pandemic has swept the world. Although the current novel coronavirus mutants have decreased in pathogenicity and virulence compared with the original strains, and most patients have a good prognosis, the solid organ transplant (SOT) recipients are vulnerable to novel coronavirus. And even with vaccination, the risk of hospitalization or death is still high in SOT recipients infected with novel coronavirus. What′s more, the clinical manifestations, diagnosis and treatment strategy of SOT recipients infected with novel coronavirus has its unique features, which need high attention. At present, there is a lack of guidelines or consensus in the diagnosis and treatment field of novel coronavirus for such a large number of SOT recipients. Therefore, referring to the "Diagnosis and treatment plan of coronavirus (Trial Version 10)" and global published literature, the writing team wrote the "Expert consensus on diagnosis and treatment of novel coronavirus infection in solid organ transplant recipients (2023 edition)" . This consensus was evidence-based written and reached by experts after multiple rounds of discussions, forming 21 recommendations, providing reference for the diagnosis and treatment of SOT recipients infected with novel coronavirus.

The immune system is the important guarantee for maintaining the health of organ function and preventing diseases. The goal of immune health management and immune treatment is to restore the normal function of the immune system. The technical problems of how to inhibit or enhance the immune status has been solved in the field of immunology, but how to comprehensively detect and quantitatively evaluate the immune status is still a challenge. There is no mature solution at present. The quantification detection and visualization evaluation of immune status are of great significance for disease prevention and control, sub-health status management, and immune treatment. This expert consensus has carried out preliminary discussions on the definition of normal immune status and the comprehensive quantitative evaluation and visual scoring techniques of immune cell function status (immune function), put forward the basic concepts and thinking related to normal immune status, discussed the direction and principles of quantitative detection and evaluation of immune cell function status, and taken this as an opportunity to promote the decoding of immunity and the study of basic and clinical trials in the field of immune health.

自2019年新型冠状病毒感染(COVID-19)首次发现以来，截至2022年12月21日，全球确诊病例已超过6.49亿例，且死亡病例达660多万例^[1]。目前我国境外输入和本土疫情的新型冠状病毒(以下简称"新冠病毒")主要流行株是奥密克戎变异株^[2]。该病毒变异株传染性更强、传播速度更快、再感染率更高，在已接种新型冠状病毒疫苗(以下简称"新冠疫苗")的人群中易发生免疫逃避及突破感染^[3]。实体器官移植受者(solid organ transplant recipient，SOTR)因长期使用免疫抑制剂，且可能伴有高血压、糖尿病等慢性基础性疾病，感染新冠病毒后重症率和病死率均高于普通人群^[4]。按照中华人民共和国国家卫生健康委员会印发的《新型冠状病毒感染诊疗方案(试行第十版)》^[5]中将"免疫功能缺陷(如长期使用皮质类固醇或其他免疫抑制药物导致免疫功能减退状态)"人群列为重型/危重型高危人群之一。因此，应高度重视SOTR感染新冠病毒的健康管理，优化其预防、早期诊断和治疗策略。

Post-transplant diabetes mellitus (PTDM) is a common endocrine and metabolic disorder after adult solid organ transplant (SOT), affecting 10% to 40% of recipients. PTDM has been associated with increased mortality, heightened risk of infections, graft-related complications and cardiovascular diseases, all of which seriously threaten the quality of life and long-term survival of recipients. According to recent studies and the domestic healthcare system, this consensus provides a comprehensive overview of the epidemiology, risk factors, pathogenesis, screening and diagnosis, treatments, prevention strategies, cardiovascular risk factor management and microvascular complications associated with PTDM, in order to further standardize the diagnosis and treatment of PTDM. The objective is to standardize the comprehensive management of PTDM with the aim of enhancing the long-term quality of life and clinical outcomes for SOT recipients.

肝移植是治疗终末期肝病最有效的方法。随着外科技术和免疫抑制药物的发展，肝移植受者和移植物生存率已显著提高。根据中国肝移植注册中心(China Liver Transplant Registry，CLTR)数据，2015至2021年我国共实施肝移植35 566例，公民逝世后器官捐献肝移植和活体肝移植受者术后1、3、5年生存率分别为83.7%、74.5%、68.9%和92.4%、89.3%、88.2%^[1]。肝移植受者的长期存活和生存质量很大程度上取决于术后中长期健康管理和免疫抑制方案。长期服用免疫抑制剂可导致受者出现肾损伤、代谢性疾病和新发恶性肿瘤等严重并发症，甚至增加肝癌肝移植术后肿瘤复发风险^[2]。目前肝移植受者常用的免疫抑制方案以钙调磷酸酶抑制剂(calcineurin inhibition，CNI)为基础，其中以他克莫司+吗替麦考酚酯(mycophenolate mofetil，MMF)+泼尼松方案最为普遍。但是CNI引起的肾脏毒性、神经毒性和促进肿瘤复发等问题极大地影响了受者预后，近年来临床逐渐减少其用量并寻求替代药物。

Antibody-mediated rejection (AMR) is proved to be a crucial complication in heart transplantation, which has not been well evaluated and studied in China. Nowadays, it is considered that AMR contains a series of evolution process from pathological changes to clinic manifestation, which starts with the accumulation of immune factors (such as antibody, complement), the activation of complement and ends with graft tissues injury. Clinically, AMR was classified as circulating antibody silent stage, sub-clinical stage and symptomatic AMR stage. The mechanism of AMR involved in an inflammatory reaction induced by deposition of immunoglobulins and complements within the microvessels of the grafts, in which the activation of complements played a core role. Therefore, immunological assay of C4d and C3d in endomyocardial biopsy specimens combined with evidence of histopathology capillaries injury were necessary for the diagnosis of AMR. While noninvasive gene detection with Allomap and donor-derived cell-free DNA were effective method serving as screening and monitoring AMR. Recommendations on management of AMR consisted a combination of corticosteroid, intravenous immune globulin, plasmapheresis or rituximab by scale of AMR, which were proven to be effective against immune injury. However, the efficacy of anti-CD52 monoclonal antibody, eculizumab and photochemotherapy remains to be further evaluated.

Sarcopenia is a group of systemic,progressive skeletal muscle diseases characterized by decreased muscle mass and muscle function due to a variety of etiological factors.The incidence of sarcopenia in liver transplant recipients in China exceeds 40%, which seriously restricts the efficacy of liver transplantation.To standardize and optimize the diagnosis and management of sarcopenia associated with liver transplantation, the Liver Transplantation Group, Branch of Organ Transplantation of Chinese Medical Association; Branch of Organ Transplant Physicians of Chinese Medical Doctor Association have organized experts to summarize and discuss the clinical diagnosis and management of sarcopenia associated with liver transplantation in China by combining the evidence-based medical basis and China's clinical practice experience, and by drawing on the relevant domestic and international literature.This guideline focuses on the diagnosis, assessment, clinical prevention and treatment of sarcopenia related to liver transplantation, and puts forward a series of recommendations in a scientific and standardized way, aiming at optimizing the perioperative and even mid-and long-term health management of liver transplantation in China.

Liver transplantation is recognized as the most effective treatment for end-stage liver diseases. In addition to excellent surgical skills, postoperative ischemia reperfusion injury (IRI) and rejection are important factors affecting the prognosis, long-term survival and life quality of patients. Kupfer cell (KC) is resident macrophages in the liver, which plays a crucial role in the process of IRI, rejection and immune tolerance after liver transplantation. This review summarizes the current status and progress of the research on the effects of KC on IRI, rejection and induction of immune tolerance after liver transplantation.

Nanotechnology is a new research direction in tissue engineering of tracheal grafts. Nanotechnology involves not only the nano biomaterials, but also the generation technology of nanofiber structure. Nano biomaterials are mainly divided into inorganic and organic, but in the specific operation, organic nano biomaterials have a broader prospect. There are three main types of nanofiber structure generation technologies: electrospinning, self-assembly and phase separation. Compared with the latter two technologies, electrospinning technology is more convenient and cost-effective. The purpose of this article is to review some important nano biomaterials, the application of nanofiber structure generation technology in tracheal grafts and the prospect of nanotechnology in tracheal grafts.

To enhance the clinical expertise in the diagnosis and treatment of invasive aspergillosis(IA)in kidney transplant recipients in China, the Branch of Organ Transplantation of Chinese Medical Association organized experts from both organ transplantation and infectious disease specialties.Drawing from existing clinical guidelines, systematic reviews, case studies and expert consensus, they synthesized and consolidated challenges encountered in the diagnosis and treatment of IA in kidney transplant recipients at home and abroad in recent years.Following multiple rounds of expert discussions that culminated in consensus, the Clinical diagnosis and treatment guideline for invasive aspergillosis in kidney transplant recipients in China were developed.This guideline encompasses 10 clinical questions and formulates 13 recommendations.Based on the 2009 Oxford University Center for Evidence-Based Medicine′s criteria for evidence grading and recommendation intensity, the strength of recommendations and the level of evidence for each clinical question were categorized.This guideline aims to enhance clinical practice and improve the long-term survival rate of kidney transplant recipients.

Liver transplantation is an effective treatment for end-stage liver diseases, and an appropriate immunosuppressive regimen is fundamental to ensuring the long-term survival of both the graft and the recipient.Mycophenolic acid (MPA) derivatives are integral components of the basic immunosuppressive regimen for liver transplantation recipients.Mycophenolate sodium (MPS), the sodium salt of MPA, is used for the prevention of rejection in liver transplantation and the optimization of immunosuppressive protocols.The Liver Transplantation Group, Branch of Organ Transplantation of Chinese Medical Association, and Branch of Organ Transplant Physicians of Chinese Medical Doctor Association organized experts to summarize and discuss the mechanism, clinical applications, and considerations for the use of MPS in combination with international guidelines and clinical practice,aiming to provide guidance and suggestions for the clinical application of MPS in liver transplant recipients.

游离DNA(cfDNA)反映其来源细胞的病理生理状态，已经广泛应用于肿瘤和产前基因检测。在器官移植领域，供体来源游离DNA(ddcfDNA)作为一种无创"液体活检"标志物在肾移植中越来越被重视，其在各种疾病状态中的价值和意义逐渐被阐释。中国肾移植供体来源游离DNA应用与研究专家组和中国医药生物技术协会移植技术分会组织相关专家参考国内外最新进展，结合我国肾移植临床实际撰写了初稿，广泛征求国内本领域临床一线专家修改意见后统稿完成本共识。共识围绕cfDNA检测与ddcfDNA计算、标本留取规范、ddcfDNA绝对值和相对值的意义、ddcfDNA与移植肾排斥反应(包括与移植肾损伤/排斥反应、供体特异性抗体、亚临床排斥反应、移植肾活检病理的关系、在诊断小管间质性TCMR的作用)、动态ddcfDNA的监测意义、ddcfDNA与儿童肾移植、重复肾移植、肾小球滤过率、移植肾BK多瘤病毒感染及ddcfDNA检测的影响因素等十个方面进行了论述，并给出了相关专家推荐意见。

At present, China′s transplantation surgery has ranked second in the world.Donation of brain death organs is the main source of organs. However, there is an imbalance in supply and demand development between organ donations and organs transplantation, it is urgent to improve the quality of clinical management of potential donors of brain death, optimize the quality of donation organs, and improve the conversion rate of potential donors. Nursing management plays a very important role in the maintenance of potential organ donors of brain death. This consensus focuses on the nursing points of the system of brain death potential organ donors during the nursing process, and scientifically and regulates recommendati- on opinions, aiming to improve the nursing management system of potential organ donors for adult brain, thereby improving the quality and donation rate of donation organs.

Liver transplantation is the most effective treatment for end-stage liver diseases.Although the liver has a unique immunological microenvironment, resulting in significantly lower incidence and severity of rejection after liver transplantation than other solid organ transplantation,rejection remains common, with incidence of 15%-25%.Antithymocyte globulin (ATG) is a concentrated anti-human T-lymphocyte immunoglobulin preparation, which is used in the immunosuppressive induction therapy for the organ transplantation to improve the survival rate of graft and recipient.The Liver Transplantation Group, Branch of Organ Transplantation of Chinese Medical Association organized experts to discuss, summarize the latest progress of relevant research at home and abroad, and elaborate the mechanism, clinical application scenarios and precautions of ATG in combination with international guidelines and clinical practice, aiming to provide guidance and suggestions for clinical application of ATG in liver transplant recipients.